Budget Impact of Improved Perioperative Reprocessing of Surgical Sets Used in Trauma Surgery in a Major German University Hospital

OBJECTIVES: Perioperative management of surgical sets is associated with substantial cost, complexity, and personnel time. The study objective was to assess the efficiency, financial, and sustainability impact of the 4S Intelligent Trauma Care program for the post operative reprocessing of surgical sets in open reduction internal fixation (ORIF) surgeries in a major German trauma center.

METHODS: A single-center, retrospective pre-post 4S implementation study was introduced to standardize inventories of instruments and implants of ORIF procedures. Data collection and budget-impact model were used to assess post-op reprocessing efficiency and cost impact of the partial and full 4S program.

RESULTS: Relative to previous practice, the partial 4S program, with pre-sterilized plates, reduced the mean number of items per set by 34%, processing complexity by 15%, number of unique surgical sets by 55%, and total volume of standard sterilization containers by 16%. The full 4S program, with pre-sterilized screws, reduced the mean number of instruments per set by 84%, processing complexity by 30%, number of unique surgical sets by 68%, and total volume of standard sterilization containers by 46%. The full 4S program reduced total costs by 43%, saving €19,382 over a one-year time horizon, and reduction in electricity, water, and chemical usage for the department of traumatology ORIF systems by 43% for cleaning and disinfection, respectively.

CONCLUSIONS: A substantial efficiency and sustainability impact is demonstrated with the introduction of the 4S program demonstrating an opportunity for the hospital reprocessing departments to reduce complexity and costs.